The Politics of Defining Gender and Sex

Gender. Sex. By the time you’re two you think you have a pretty good idea what those things are. But it turns out we generally have a very rudimentary understanding at best. Many have attempted to define the difference between gender and sex, and it’s worth looking into.  But for the purposes of this blog I want to focus on two things, first, that the definitions of both are not clear-cut, and second that defining gender and sex are political.

I recently finished reading Hermaphrodites and the Medical Invention of Sex by Alice Domurat Dreger. In seven chapters the author describes a specific historical moment and how it contributed to the definition of sex. That moment is the late 19th and early 20th century, and the biomedical treatment of hermaphrodites in France and Britain during that time. I find this history particularly interesting as it follows the foundation of modern obstetrics and the subsequent architecture of Western maternity care that we live with today.

Indeed, the boundaries of gender and sex have been a hot topic in the midwifery world recently. When the Midwives Alliance adapted its Core Competencies document to be more gender neutral in 2014-2015 some midwives protested, others responded in support, and even Snopes had to weigh in on the drama.

Gender has also been in the forefront nationally with the presidential campaign and its surrounding gender issues, the protest of hundreds of thousands of people at the Women’s Marches worldwide, and the recent Trump Administration reversal of federal policy on the use of gendered bathrooms in schools.

The Medical Invention of Sex suggests that these overlapping issues at the forefront today are no accident, and in fact, can be traced back to the late 19th and early 20th century. Indeed, can be traced back to the way that various white, male doctors, including obstetricians handled what Dreger calls “social challenges to sex borders.” Those doctors created a binary system of sex, not because that is what the evidence pointed to, but to “restore order in the laboratory, in the surgical clinic, in marital beds, in military barracks, on the streets.” 

Dreger suggests that for medical men of the era to admit what they were finding (that there were indeed people who did not fit neatly into categories of male or female in terms of both how they acted and what their bodies were like) would have added to the contemporary threat of people like “feminists and homosexuals.” So instead of a world that could make sense of and include feminists and homosexuals, the medicine men of this era invented a scientific basis for binary sex that would help keep them at bay.

As demonstrated by the backlash to gender-neutral core competencies for midwives, some people calling themselves feminists have fallen for the allure of this tidy system. They reason that childbirth is exclusive to women and that encroachment into that sex border is a fundamental threat. But the historical and scientific reality is not so tidy.

Binary notions of gender and sex were not designed by or for “women.” They certainly were not designed by or for those women, like the one introduced in the prologue to Dreger’s book who was told by a Belgian doctor in 1886, “But my god woman you are a man!”  In fact, binary notions of gender were designed by the same doctors who had women give birth in the lithotomy position and who considered midwives inherently (biologically?) inferior. 

It’s worth emphasizing that this binary does not really exist. Major mainstream publications now recognize this. Take for instance the January 2017 issue of National Geographic magazine devoted to gender.  And the Time News article entitled “Gender Laws Are at Odds With Science,” by California Superior Court Judge Noel Wise. In response to the spate of “bathroom bills” and other legal efforts to define binary sex he states:

If modern science recognizes that sex has countless natural permutations, and if birth certificates, physical observation and even chromosomal testing cannot reliably categorize every individual as either male or female, then our judiciary cannot be required to make gender findings antithetical to that reality.

Indeed, feminists, homosexuals, midwives, and those who love them should resist the notion of binary sex not only because it is inaccurate and “inconsistent with science and incongruous with the historic and modern understanding of sex throughout many regions of the world,” but because it is being used as a tool to limit us, to keep us in boxes, and serve political and religious motives that do not have our best interests at heart. In fact, it is used as a tool to determine that we can’t define ourselves.

Human diversity is real. Defining that diversity is political.  Honoring diversity as experienced by those whose definitions of themselves have not been seen, read, heard or honored is essential.